The Australian and New Zealand journal of surgery
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Twelve patients with tracheo-oesophageal fistula (TOF) and restrictive lung disease necessitating pre-operative ventilation are reported. Eight patients had respiratory distress syndrome, four had aspiration pneumonia, and 11 had associated oesophageal atresia. Two patients in whom a preliminary gastrostomy was performed died. ⋯ We believe that the presence of a TOF in a neonate with poorly compliant lungs requiring mechanical ventilation represents a serious surgical challenge. Gastrostomy alone should never be performed. Ligation of the fistula with either immediate or delayed primary repair of the oesophagus are the treatments of choice.
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Historical Article
Barbers and porters: commencement of academic anaesthesia in Australia.
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A simple system of codes for operations, diagnoses and complications, developed specifically for computerized surgical audit, is described. This arose following a review of our established surgical audit in which problems in the retrieval of data from the database were identified. Evaluation of current methods of classification of surgical data highlighted the need for a dedicated coding system that was suitable for classifying surgical audit data, enabling rapid retrieval from large databases. After 2 years of use, the coding system has been found to fulfil the criteria of being sufficiently flexible and specific for computerized surgical audit, yet simple enough for medical staff to use.
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Review Clinical Trial
The surgeon and adjuvant therapy for breast cancer.
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A new technique for split skin graft fixation using 'Hypafix' adhesive dressing is described. Ninety-three patients with burns involving less than 20% body surface area grafted at the Adelaide Children's Hospital during February 1985-May 1987 were reviewed. ⋯ The adhesive is readily loosened with Ungvita ointment allowing the dressing to be removed painlessly. In this study its use has shortened both the length of inpatient stay and outpatient follow-up in the Scar Management Programme.